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General NPI Number Information
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NPI Number | 1891893624
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Entity Type | Organization
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Legal Business Name | SOUTHWEST HEALTHCARE SERVICES
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 802 2ND ST NW
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City | BOWMAN
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State | ND
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Zip | 58623-4483
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Country | US
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Telephone | 701-523-5555
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Fax | 701-523-7107
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Provider Business Mailing Address
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Address Line | 802 2ND ST NW STE 1
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City | BOWMAN
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State | ND
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Zip | 58623-4469
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Country | US
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Telephone | 701-523-5555
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Fax | 701-523-7107
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | LISA KNOPP
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Credential | CLINIC
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Telephone | 701-523-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | ND
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